Felt a bit shitty as had to quote the Nice guidelines to get HRT

[LaurieFairyCake]

Doctor was lovely but I had to be very firm about it. The - I'm not leaving without an HRT prescription as I have a lot of the symptoms on this sheet and I feel dreadful - type of firmness. I had printed out the questionnaire from menopausedoctor.co.uk to take with me.

She wanted me to have blood tests (apparently they're useless according to websites as I'm still menstruating normally) and I said fine but I wanted a prescription for after the blood tests.

So I had my blood tests (thyroid and diabetes too) and cashed my prescription for Femoston straight after at 6pm. Thank god the local hospital does blood tests to 5.30 and my pharmacy is open til 7!

I'm going to hope they work, if not I'm going back for a referral to a menopause clinic.

Just thought I'd post this to let everyone know that you still have to be pushy as some doctors don't want to give you HRT

She was literally totally wrong about everything. Saying I needed a blood test/was too young for HRT as I was still menstruating PLUS that I could only take it for 5 years as I 'would likely get cancer'. And she also tried to say I needed a smear BEFORE HRT.

She tried EVERYTHING to put me off.

Well done, you have done well there.
I’m still battling to get HRT after breast cancer 10 years ago. My symptom are dire like yours and I’m suffering like hell. I’m hoping my latest appointment next week gives me the prescription I need!

Do you know what baffles me is when I read things like what @TitsInAbsentia mentioned
"average age for menopause is 51"
Well for that to be the average age, there has to be sufficient numbers of people younger and older for that to be the average. Confound these GP's with the maths if they don't seem to be following the science!

@LaurieFairyCake - I hope you're starting to feel more like yourself now.

It is very frustrating, I'm currently planning another go with mine after finding out recently just how far from NICE guidelines mine was (mine pretty much said, after I was cleared for other causes for on my menopausal symptoms, to be glad about buying fewer pads. By my age alone I should have had particular testing I didn't and be offered HRT to protect my bones and such).

Thanks for posting that symptom link, it's great, I've seen a few of those, but might use that one, or more than one, for my appointment. Best way for me to manage my anxiety about this, just have a ton of paperwork that I can point to rather than relying on my own memory.

Nice Guidelines say blood tests for over 45s aren't recommended or much use and should just use symptoms, and a couple blood tests are only typically recommended for those younger, particularly under 40. I had them, but I was under 30 at the time. I've found Menopause Matters and their decision tree and the guidelines very helpful in understanding what is meant to happen, crossing my fingers it hopes me get the help I'm meant to have...

I have a very supportive GP. Can’t have HRT for medical reasons and have just started on a 2 week trial of an AD. The change in my sleep, hot flushes and night sweats has been immediate and remarkable!
However I still feel tired (but no longer the bone crushing type, more lethargic) and I’ve got aching knees and hips. What else can I do?

It's your doctor who should feel not just shitty but extremely embarassed that a patient knew more about best medical practice than they did.
I always tell friends to read up and quote from the NICE guidelines if their doctor is reluctant to prescribe HRT. If that doesn't work insist on a referral to a menopause clinic. They are bang up to date.
As to how long you can be on it - I am fortunate to have as my consultant one of the top specialists in the UK (she is one of the contributors to the NICE guidelines) I have been on estradiol implants for 30 years now and she sees no reason why I should ever stop.
I look and feel at least 10 years younger than my peers, have no osteoporosis, and an excellent quality of life.
I see her twice a year, have my implant inserted and forget about menopause for the remaining 363 days of the year. I highly recommend it.

PeachNut

Are you sure that you cannot have HRT?

Time after time women come here to say they can't and 9 times out of 10 they have been denied it by drs who are out of touch.

The only reasons not to are recent breast cancer and a recent heart attack or blood clot.

Sorry in advance if any of those are your reasons, but so many drs refuse HRT for the wrong reasons.

jingling my GP says yes, it’s my consultant that says no.

Well done Laurie. I had opposite problem, GP just trying to give me HRT when I needed proper investigation and am now on list hysterectomy having had a failed fibroid embolisation. Consultant said HRT would have made fibroid larger.

GP here- just wanting to put in our perspective. Im really pro HRT (if thats what the patient wants). i have no problems prescribing it with women who have peri meno type sx still with reg periods. Agree blood tests are useless over 45.

HOWEVER. pls don't always assume that you have a shit GP if you don't walk away from the first appointment without a prescription. there is SO much information and options with peri meno/ menopause that it takes time to talk thru them and explain properly about how to use/take them. it simply can't be fit within ten minutes start to finish and do it properly (and if it was, believe me it was rushed!!).so i usually spend 2 appointments (which i book when they are in the room with me to avoid the hassle of trying to get an appointment) and then further f/u at 3 months, as i feel this does it justice. also, there are LOADS of different options your GPs can try... so maybe give them a chance before demanding referrals (as it will be quicker in the long run for you too!)

My request for HRT took nearly 18 months. Tested at 44 which confirmed peri. I'm 51 now and haven't had a period for nearly 3 years. So yeah one of the ones below the average age.

The various GP's went through the whole lot - blood tests needed, repeat blood tests needed, take some black kosh/ St Johns Wort/every other herbal remedy that one woman once said helped a little bit, have these ADs they are just as good, breast cancer risk, heart disease and stroke risk (with no family history of any), weight gain, you'll need to come off them in 5 years anyway and all your symptoms will just come back, we need some more blood tests etc. etc.

In desperation at one point I did take the ADs and they helped a little with the hot flushes but I stopped taking them really quickly because I found out they were contra-indicated for 2 other conditions I had and had also been found to lower blood pressure - guess what, my blood pressure was at the lower end of normal at that time. So I was prescribed some ADs that could have done some real damage to me instead of HRT which could have helped me. WTF is so wrong that that is where I ended up?

At the appointment where I was given HRT I sat in the room with the NICE guidelines on my lap flicking through the pages during another grilling on why I wouldn't just carry living with the effects of menopause or take the latest herbal magic.

The only reasons not to are recent breast cancer and a recent heart attack or blood clot.

I'm fatally allergic to progesterone. I know progesterone is not in all HRT, but I couldn't take one it was in.

So, there might well be other reasons than those you have listed.

@VanGoghsDog

If you were you'd be dead now. :)

You have high levels of progesterone in your body every monthly cycle, post ovulation.

What makes you say you are 'fatally allergic to progesterone'?

One type of HRT has exactly the same as we have ourselves.

@JinglingHellsBells

Well that's a bit fucking rude. An immunologist after a raft of tests, following extend swelling all over my body including my face and mouth. Is that OK for you?

Obviously I'm not allergic to the progesterone my own body produces. There are a number of different types even in contraception.

I can have the Merina coil, for example. But the family of progesterone used in the POP caused the issue - an issue which is so rare my GP had to report it to the manufacturer.

The consultant decided not to risk me having any other oral progesterone, nor implants or the injection. They decided to try the coil with close monitoring as it works differently and the progesterone is a different type, plus it can be removed quickly and easily if necessary.

Before they worked out what was causing the allergy I had to carry around steroids and antihistamines, one of which I had to immediately take eight tablets of if the swelling started and go straight to A&E. Luckily I had private medical cover at the time and got the immunology appointment within days of the GP referral.

Plus, you don't actually know what levels of progesterone I have in MY body, do you? I've had many hormonal issues over the years and I may well have an imbalance.

I am peri menopausal and very concerned about potentially needing HRT.

No it's not f....g rude, it's a medically correct fact.

I wanted to correct you because your post may scare other women and it's incorrect.

From what you say you are not even using/ used HRT- it's for contraception? yes?

Totally different.

You must know WHICH type of progestogen you used and that doesn't suit you. That's fine. But you didn't say that .

You clearly were allergic not to progesterone but to one of the synthetic progestogens. Different.

Obviously I'm not allergic to the progesterone my own body produces

Yes, well , this very same progesterone is available as HRT (I use it and so do thousands of women.)

Utrogestan (aka micronised progesterone) is identical to our own. it's call 'body identical'.

You can use the Mirena, which is a type of progestogen.

You couldn't use ONE sort.

Maybe Norethisterone?

So, there are many other types used in HRT. Just because you had a reaction to one sort (as birth control?) is not the same as all,

So no, I'm not being rude and you implied you have used HRT.

I'm shocked that a smear test was offered before HRT. It reminds me of when my GP that tried to hold my BC hostage until I had the test. No consideration of informed consent. Smear tests are a diagnostic tool. If your GP is this clueless, I'm not surprised you had to fight for HRT. Well done OP.

@JinglingHellsBells

In no way did I imply I was taking HRT.

I don't feel the need to explain every intricacy of my own medical issues, I was merely giving an example of how there might be other reasons people can't take HRT.

Your post is helpful but there is no need to be so ridiculously scathing to someone you don't know.

@VanGoghsDog

I'm sorry you mis-read what was supposed to be a humorous quip for being 'fucking rude' and 'ridiculously scathing'. Goodness if that was my intention, believe me, I'd make a far better job of it! You seem to have completely over reacted to what was a meant as a light comment. Puzzled how that wasn't obvious and you felt the need to lash out.

Anyway....

If you want advice on something that is a bit off-topic, you might get more help by starting a new thread.

In any case, the good news is that if you can tolerate the Mirena coil all you need as HRT is some type of estrogen to add to it (pill, patch, gel.) Many consultants regard that combination as the best of all, so you could have found a silver lining from the allergic reaction you had.

That really is shocking OP, I'd have totally collapsed without HRT and would have been unable to function for the past 10 years.
The menopause really affected my career and personal life.
My (male) GP has been amazing, has changed my HRT several times until I found the one I got on with and listened to all of my concerns.

Good for you, OP. I suffered all the symptoms you are describing, with crashing fatigue and brain fog being by far the worst. And I had no idea it could be menopause because my periods were still regular. Pretty sure looking back it was perimenopause. I lost years - years of my life, loads of income and had to withdraw from a PhD all due to it. I wonder if HRT would have helped.

When I was suffering all of those symptoms I cried in the GPs room. She said “us women are very complicated” and told me to get some over the counter sleeping pills. I immediately booked an appointment with a private menopause specialist.

I’m on month 3 of patches - I had 2 x blood tests which found low iron, took tablets it went up, went back as symptoms the same (anxiety, poor sleep, heart palpitations, low mood before period etc). Got patches eventually and it has been miraculous - I’m sleeping soundly and anxiety and brain fog has gone. I was the same about work - I would arrange important meetings for certain times of the month it was so obviously connected to my cycle. I’m 48 btw. My go gave me 2 months to try it and I’ve carried on. You don’t have to be on it forever - a year or two might be all you need. It costs £9 a pack tho!

I wasn't asking for advice, where did you get that impression?

I doubt very much that I'll still have the Merina when I need (if I do) HRT. It's due to come out in two years anyway.

Let's just leave this. It's hijacking the OP's thread and not really relevant, other than to clear up any confusion over allergic reactions to a drug.

You might not have asked for advice but you did say this I am peri menopausal and very concerned about potentially needing HRT.

As someone who comes to this forum to offer help, I took your comment as implying you might appreciate some insights ( advice.)

Clearly that was a mistake.

Ok so an update after the blood tests. My doctor says I'm not in menopause and she suggested a gynaecologist referral.

She says my blood tests are as follows:

Hormone 9.2
FSH 16.7
Iron 37

I didn't hear what she said for tsh or diabetes.

I'm on day 5 of the HRT and feel better in the mornings but get completely wiped out and very irritated by the afternoon. I had to change tubes earlier because there was a school party on there and I felt so irritated (not normal for me)

I asked about a referral to a menopause clinic and I think she said the Margaret Pyke centre (I've googled and it's not a menopause clinic so I'm going to have to go back to the doctors).

But her English isn't perfect and she just kept saying I'm NOT in menopause.